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Updated on October 11, 2021

How Does Alcohol Affect The Brain?

How Does Alcohol Impact Your Mental Health?

Heavy alcohol use negatively impacts reasoning and overall brain function. It can lead to depression, anxiety, mood disorders, and self-harm (e.g., suicide and cutting).

Regularly drinking four or more alcoholic drinks per day also increases a person’s risk of hippocampal shrinkage almost six times compared to nondrinkers. The 'hippocampus' is the part of your brain that stores memories and aids in learning.

Alcohol and Your Brain

The following factors determine to what extent alcohol negatively impacts the brain:

  • How often and how much alcohol one drinks
  • When you started drinking alcohol
  • Your general healthcare status
  • Gender, genetics, family healthcare history, education level, and age
  • If you are at risk of prenatal alcohol exposure

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Alcohol and Brain Chemistry

Alcohol abuse changes your brain’s chemistry. Alcohol leads the brain's reward system to release the motivational chemical dopamine. Therefore, consistent alcohol consumption can lead to both short- and long-term psychological issues.

How Does Alcohol Affect the Brain in the Short-Term?

When an individual drinks alcohol regularly, it can adversely affect the brain, especially in the prefrontal cerebral cortex and areas of the cerebellum. The prefrontal cortex associates with executive functions such as planning and decision-making. The cerebellum is connected to balance and motor function.

When these parts of the brain are affected, it can lead to various side effects and problems, including:

  • Memory problems
  • Poor reflexes and coordination
  • Reduced cognitive performance
  • Vision difficulties
  • Trouble focusing
  • Lack of confidence
  • Mood swings
  • Reduced stress
  • Multitasking
  • Alertness
  • Speech
  • Normal thoughts
  • Blackouts

Even small amounts of alcohol can lead the whole brain to shrink if consumed habitually over a long period. The reasons for this brain shrinkage are unclear. However, research from the Boston University School of Publish Health shows that alcohol consumption dehydrates tissues, and consistent dehydration can have adverse effects on sensitive tissue.

Other studies suggest that smaller brains (common in alcoholics) are also lighter than those who do not have an alcohol use disorder. Some of the damage can be reversed if the individual decides to stop drinking.

How Does Alcohol Affect the Brain in the Long-Term?

Studies indicate a link between excessive alcohol consumption and complex long-term brain issues, some of which are the direct result of heavy drinking.

Heavy drinking while pregnant can also lead to fetal alcohol syndrome. Fetal alcohol syndrome can contribute to various brain and central nervous system problems in the fetus, including permanent brain damage and many physical defects.

Serious psychological long-term effects of alcohol use include:

  • Higher chance of developing depression or an anxiety disorder
  • Higher risk of committing suicide
  • Increased alcohol tolerance—this results in heavier drinking to achieve the same effect
  • Increased risk of developing alcohol use disorder (AUD)
  • Irregular brain development
  • Permanent changes to brain chemistry
  • Permanent memory loss
  • Reduced learning capabilities

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Common Memory Disorders Associated With Alcohol

Alcohol consumption limits the brain’s ability to transfer information from your short-term memory to long-term storage. This is because heavy alcohol use changes your neurons, which results in smaller brain cells. Over time, and with continued alcohol use, it becomes more difficult to remember previous experiences and simple daily tasks.

Additionally, long-term alcohol use links to many serious memory disorders. A few common disorders include:

Widespread Brain Atrophy

As mentioned above, alcohol use shrinks the brain and decreases the size of brain cells. People who have an alcohol use disorder (AUD) appear to have smaller brains than moderate and non-drinkers. AUD (previously called alcoholism) is a severe and chronic disorder that results in an uncontrollable dependence on alcohol. Symptoms of brain atrophy include:

  • Changes in mood, personality, or behavior
  • Disorientation
  • Learning impairments
  • Memory loss
  • Difficulties with judgment or abstract thinking
  • Challenges with comprehension and thinking
Wernicke-Korsakoff Syndrome

Some researchers believe Wernicke and Korsakoff syndromes are separate yet related disorders. Others believe them to be different stages of the same disorder or disease spectrum. Wernicke syndrome is considered the acute phase with a shorter duration and more serious symptoms. Korsakoff syndrome is considered the chronic phase and is a long-lasting condition.

Both of these conditions develop suddenly due to thiamine deficiency. In many cases, those with AUD are deficient in vitamin B1. So, they have a higher risk of developing these disorders.

Wernicke syndrome is characterized by the clinical triad of mental status changes (e.g., confused state), the inability to coordinate voluntary movement (ataxia), and eye abnormalities. Affected individuals may not display all three symptoms. Other signs of Wernicke’s include:

  • Mild memory loss and confusion
  • Sudden disorientation and trouble balancing
  • Excessive weight loss and malnutrition
  • Involuntary eye movements
  • Muscle paralysis in the eyes
Korsakoff Syndrome

If Wernicke’s syndrome is left untreated, Korsakoff syndrome will likely develop. Korsakoff psychosis forms due to permanent damage in critical small areas deep within the brain.

Korsakoff syndrome is characterized by memory impairment, specifically short-term memory loss (i.e., the inability to form new memories). In some cases, affected individuals may also have random loss of long-term memories. In rare cases, individuals may create imaginary events to fill in gaps in their memory (confabulation).

Alcoholic Dementia

Similar to Korsakoff syndrome, alcoholic dementia is a form of alcohol-related brain damage that results in memory loss. However, symptoms of Korsakoff syndrome are typically more severe than those associated with alcoholic dementia.

Mental Health Disorders and Alcohol

Long-term alcohol abuse directly impacts brain function and alters your brain chemistry (neurotransmitters). In addition, alcohol consumption affects the hormonal systems in your body associated with common mental health conditions. Due to alcohol’s depressive effect, those with AUD also have a higher risk of attempting suicide and engaging in self-harm.

Common mental health disorders associated with heavy alcohol use include:

Depression

Depression, which is a group of conditions that lower a person’s mood, affects about 80 percent of alcoholics at some point. Depression comes in many forms, including clinical depression, persistent depressive disorder, and bipolar disorders, among others. The effects of alcohol can come in waves throughout life or can be long-term.

Since alcohol is a depressant, the substance enhances the symptoms of depression due to its sedative effects.

One study found that 25 percent of people experience depression after binge drinking (consuming a large amount of alcohol quickly). About 33 to 50 percent of people with AUD also struggle with depression.

Anxiety Disorders

Anxiety is a common condition that leads to constant worrying about daily situations. Alcohol-induced anxiety is separate from an independent anxiety disorder, but they are often hard to differentiate. Although, the symptoms of alcohol-induced anxiety usually appear during alcohol withdrawal. They also tend to resolve quickly with treatment and continued abstinence.

Certain anxiety disorders, including social phobia, PTSD, and panic disorder, have an increased co-occurrence with alcohol dependence. Many people abuse alcohol to suppress the symptoms of their anxiety disorder temporarily. What many people do not know, however, is that alcohol abuse makes anxiety worse. Alcohol use also has high rates of producing panic attacks, which can turn into panic disorder.

Self-Harm and Suicide

Many people drink alcohol to self-medicate. However, alcohol is a depressant. It also links to many mental health disorders, such as depression. As a result, the risk of self-harm is high among alcoholics. This may include self-inflicted injuries, such as cutting, or suicide.

If you or a loved one is self-harming or considering suicide, it is essential to seek medical advice as soon as possible.

People with AUD are 60 to 120 times more likely to participate in self-harm and commit suicide than those free from psychiatric illness.

Treatment Options for Alcohol Abuse & Addiction

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These prograInpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. However, they may be longer in some instances. Throughout an inpatient program, you will live on-site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterward.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program. Some PHPs provide food and transportation. However, this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat AUD. MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.
  • Support Groups Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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Resources

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Alcohol’s Damaging Effects On The Brain. U.S. Department of Health & Human Services. October 2004. https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm

“Korsakoff's Syndrome.” Alzheimer's Society, www.alzheimers.org.uk/about-dementia/types-dementia/korsakoffs-syndrome.

Merz, Beverly. “This Is Your Brain on Alcohol.” Harvard Health Blog, 13 July 2017, www.health.harvard.edu/blog/this-is-your-brain-on-alcohol-2017071412000.

Ramesh S., M.D., et al. Alcoholism and Psychiatric Disorders. Alcohol Research & Health. 2002;26(2): 90-98. https://pubs.niaaa.nih.gov/publications/arh26-2/90-98.htm

Ritchie, Craig, and Abel Koshy. “Faculty of 1000 Evaluation for Moderate Alcohol Consumption as Risk Factor for Adverse Brain Outcomes and Cognitive Decline: Longitudinal Cohort Study.” F1000 - Post-Publication Peer Review of the Biomedical Literature, 2018, doi:10.3410/f.727689951.793543102, https://pubmed.ncbi.nlm.nih.gov/28588063/.

“Symptoms of Alcoholic Dementia.” Alzheimer's Society, www.alzheimers.org.uk/about-dementia/types-dementia/alcoholic-dementia.

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